Diabetes and Arthritis: Decoding the Link
By Sara Lyle
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Close to 30% of adults with diabetes also have arthritis. Here are some strategies – including medication and lifestyle changes – to manage both conditions.
Lesley Lyle’s last decade has been a delicate juggling act of health challenges.
At 42, she was diagnosed with type 2 diabetes after enduring two years of mysterious gastrointestinal issues.
“I could only eat rice and Cheerios,” the single mother from Florida recalled.
In 2020, Lyle (pictured on the left with her family) was diagnosed with psoriatic arthritis, a painful joint condition she shares with her mother. Unfortunately, the treatments led to uncomfortable allergic reactions, made worse by an alarming visit with a rheumatoid specialist who resorted to Googling "psoriatic arthritis."
“I never went back,” she said.
Her present endocrinologist is “so confused” by Lyle’s symptoms – which now encompass thyroid complications and dysfunction in both the pancreas and adrenal glands – that she wants blood work done to determine if Lyle might have type 1 diabetes instead.
Lyle's complicated health story illuminates the relationship between diabetes and arthritis. Nearly 30% of adults with diabetes also have arthritis, according to the Centers for Disease Control and Prevention. Additionally, individuals with arthritis face a 61% higher risk of developing diabetes compared to those without it.
Those with autoimmune forms of arthritis, like psoriatic arthritis and rheumatoid arthritis, may also be at higher risk for developing diabetes.
Connecting the dots between diabetes and arthritis
Dr. Alberto Chavez Velazquez, an endocrinologist at the Texas Diabetes Institute, acknowledges the similarities between type 1 diabetes and inflammatory arthritis. For example, both involve the immune system mistakenly attacking its tissues.
However, Chavez notes that the risk of joint issues isn't limited to those with type 1 diabetes. Individuals with prediabetes may also have connections to specific forms of arthritis. These links, he explained, can be attributed to lifestyle factors and the presence of inflammation (inflammation is also thought to play a key role in the development of type 2 diabetes).
Other factors Chavez said contribute to both type 2 diabetes and arthritis are aging and living with obesity or excess weight, which can accelerate or complicate chronic conditions like these.
Lifestyle strategies for improved quality of life
Weight management is crucial for managing and relieving symptoms of arthritis. One study found that significant weight loss (10-20% of body weight) over time can significantly reduce arthritis pain.
Meanwhile, the American Diabetes Association recommends weight loss and increased physical activity to ward off or reverse prediabetes. One of the most effective ways to achieve such weight loss? Getting more exercise and reducing caloric intake (this is also important for people already diagnosed with diabetes).
However, this advice can present unique challenges for people dealing with both arthritis and diabetes.
“They might say, ‘My joints hurt all the time’ or ‘I have limited mobility,’” said Chavez. For such patients, low-impact exercises like swimming or passive movement like stretching are prescribed.
“Once patients lose weight, there's a lot less stress in their joints. I’ve seen people who used to come in with a cane and are now walking without pain,” he said.
Chavez is a big proponent of quality sleep, too, highlighting a recent trend linking poor sleep to increased risks for obesity and diabetes. In addition, individuals with sleep apnea are more prone to high blood pressure and cardiovascular events. As such, he encourages patients to undergo a sleep assessment for a comprehensive understanding of their health risks.
Other lifestyle changes Chavez recommends include limiting tobacco and alcohol consumption, maintaining adequate hydration, managing carbohydrate intake, and adopting a diet low in saturated fat.
Medication for diabetes and arthritis
Beyond adopting healthy lifestyle changes, certain medications can benefit both type 2 diabetes and arthritis. These include GLP-1 receptor agonists like Ozempic, Victoza, and Trulicity.
Along with encouraging weight loss, these drugs address insulin resistance and inflammation, potentially improving joint health – or, as Chavez describes it, “doing double duty."
He also underscored the importance of making informed decisions, particularly for people with arthritis who are at risk of developing diabetes.
“Frequently, arthritis patients get treated with steroids or glucocorticoids like prednisone,” Chavez said. “These agents are well known to induce insulin resistance and, at higher doses, can make people develop diabetes versus other medications without these side effects. You have a choice.”
For these reasons, he contends that an endocrinologist or a rheumatologist alone can’t treat people with interrelated conditions (like Lyle) and strongly recommends a multidisciplinary team to manage such complexities.
"We practice in an era where medicine is more and more individualized,” he said. “There is no recipe that applies to everyone."
Learn more about diabetes, lifestyle changes, and related conditions here:
